Andrew Lobashevsky, MD, PhD

Associate Professor of Medicine

Bio

Andrew Lobashevsky MD,PhD, D(ABHI)- Diplomat of American Board of Histocompatibility and Immunogenetics is Associate Professor and Histocompatibility Laboratory Director at Department of Medicine of Indiana University and Clarian Health Partners Inc. Dr. Andrew Lobashevsky joined the IU Department of Medicine in December 2004, as the Directory of the Immunology-Histocompatibility Laboratory. Previously, Dr. Lobashevsky was the Co-director of the HLA Laboratory at the University of Alabama at Birmingham Transplant Center, the third largest center in the country. Dr. Lobashevsky received his medical education and postgraduate training at the Department of Immunology and Microbiology of Sechenov’s Medical Academy, Moscow, Russia. He had his post-doctoral training in cellular and molecular immunology at the University of Tennessee at Memphis, and received transplant immunology/histocompatibility training at the University of Alabama at Birmingham. The laboratory headed by Dr. Lobashevsky is focused on providing service for the solid organ transplant programs as well as the bone marrow transplant activities of the Hematology/Oncology division at IU.

In early 2005, the transplant program at IU initiated the use of desensitization protocols which include the use of intravenous immunoglobulin, both with and without plasmapheresis. Desensitization is widely used to decrease percent of reactive antibodies in solid organs transplant candidates. Various numbers of cycles of desensitization are required to decrease the level of donor specific antibodies. We hypothesized that there was a correlation between polymorphis of some cytokine genes and intensity of desensitization required to make the recipient/donor cross match compatible. The results of the study showed that analysis of polymorphism (SNP) of genes encoding IL-4R, IFNã and IL-12 enables to define thedesensitization strategy in transplant candidates more accurately regarding the number of plasmapheresis cycles and dose of intravenous immunoglobulin. Structural Basis of HLA Compatibility. I have been working on this project since 2004. Through factor analysis of the data, there was a significant contribution to understanding of the mechanism of humoral response to mismatched HLA in heart and kidney recipients. This project generated preliminary information about HLA epitope immunogenicity. My subsequent input in this project was related with submitting, analysis and discussion of the data generated on basis of antibody specificity/epitope/eplete analysis using highly sensitive LUMINEX solid phase method. This will have tremendous clinical impact on donor selection.

The HLA Laboratory clinical research contributions include many promising projects. Besides histocompatibility testing for hematology/oncology patients, the laboratory also provides service for patients with a diversity of immunodeficiencies.A collaborative study between the IU Hematology/Oncology Bone Marrow/ Stem Cell Transplant group and Cylex has been established through this laboratory. The goal of this project is to determine if there is a correlation between the CD4+ T helper activation ImmuKnow test results and the risk of GVHD in hematologic malignancy patients subjected to a myeloablative pre-transplant regimen. Over the past two years, the laboratory contributed to the development of highly sensitive real time polymerase chain reaction (RT-PCR) technology to detect donor-specific signals in the recipient’s tissues. This service is provided primarily for the liver and intestine transplant program. The main purpose of this test in multi-visceral transplant (MVT) recipients is to evaluate the risk of GVHD before patients develop clinical symptoms. This might allow earlier treatment and should lead to improved patient outcome. Effect of minor HLA (allelic) mismatches on graft outcome in hematopoietic stem cells transplant recipients.I have been working on this project since January 2006. Vast majority of the recipients receive perfectly matched related or unrelated (MUD - matched unrelated donor) HSCTs. However, in the case of rare allele(s) it is not easy to find perfectly matched donor. The situation becomes dreadful when patient’s clinical condition is poor; i.e. there is no time to wait until MUD will be found. Under these circumstances, one or two minor (allelic) mismatched donor is an option.

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About

IU School of Medicine is the largest medical school in the US and is annually ranked among the top medical schools in the nation by US News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.